Public health response to an outbreak of Legionnaires’ disease in Edinburgh, United Kingdom, June 2012

McCormick, Duncan; Thorn, SN; Milne, Dona; Evans, C. Lawrence; Stevenson, J; Llano, Melissa; Donaghy, Martin

doi:10.2807/ese.17.28.20216-en

Cited by 22 publications

(14 citation statements)

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“…About 10 years ago, the largest outbreak ever reported affected 449 cases in Murcia, Spain [10]. A more recent outbreak in 2012 comprised 50 confirmed cases in Edinburgh, UK [11]. In these two outbreaks and many others, a cooling tower was incriminated as the probable source.…”

mentioning

confidence: 99%

Legionnaires' disease in Europe: all quiet on the eastern front?

2013

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mentioning

confidence: 99%

Legionnaires' disease in Europe: all quiet on the eastern front?

2013

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“…Recent events in Stoke-on-Trent7 and Edinburgh8 demonstrate the potential human cost of outbreaks of legionellosis. The financial costs of the investigation and management of 14 cases in London in 2005 was estimated to be £455 856, with 86% of costs being hospital treatment of the disease 9…”

Section: Discussionmentioning

confidence: 99%

Molecular diagnostics and the public health management of legionellosis

Yates¹,

Bruin

Harrison³

et al. 2013

BMJ Case Reports

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In 2009-2010, we investigated four legionella cases notified over an 8-month period in two adjacent villages in South East England. Molecular techniques enabled us to conclude that three of the cases had distinct infections. The absence of an adequate respiratory sample in one case necessitated epidemiological investigations to exclude a potential common environmental source of further infections. One of the cases had spent a part of their incubation period in a country in South East Asia. DNA-sequence-based typing of their isolate showed it to be of the Legionella pneumophila serogroup 1 (LP1) DNA-sequence type (ST) 481. Intriguingly, the only other two ST 481 isolates in the European Working Group for Legionella Infections database were among Dutch travellers to the same country in 2003 and 2006. This case makes clear the value of molecular diagnostics and the importance of obtaining adequate clinical specimens. The potential future uses for typing data are discussed.

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“…Although such relatively simple techniques can provide a useful estimate of the period during which exposure occurred, equations (3.2) and (3.3) provide more statistically robust estimates. Indeed, such recent advances were applied to an outbreak of LD during the summer of 2012 in Edinburgh [99] where the estimated period during which exposure occurred was used as an input into subsequent atmospheric dispersion modelling. Fusing these separate techniques into a common framework (i.e.…”

Section: Discussionmentioning

confidence: 99%

A review of back-calculation techniques and their potential to inform mitigation strategies with application to non-transmissible acute infectious diseases

Egan

Hall

2015

J. R. Soc. Interface.

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Back-calculation is a process whereby generally unobservable features of an event leading to a disease outbreak can be inferred either in real-time or shortly after the end of the outbreak. These features might include the time when persons were exposed and the source of the outbreak. Such inferences are important as they can help to guide the targeting of mitigation strategies and to evaluate the potential effectiveness of such strategies. This article reviews the process of back-calculation with a particular emphasis on more recent applications concerning deliberate and naturally occurring aerosolized releases. The techniques can be broadly split into two themes: the simpler temporal models and the more sophisticated spatio-temporal models. The former require input data in the form of cases' symptom onset times, whereas the latter require additional spatial information such as the cases' home and work locations. A key aspect in the back-calculation process is the incubation period distribution, which forms the initial topic for consideration. Links between atmospheric dispersion modelling, within-host dynamics and backcalculation are outlined in detail. An example of how back-calculation can inform mitigation strategies completes the review by providing improved estimates of the duration of antibiotic prophylaxis that would be required in the response to an inhalational anthrax outbreak.

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Public health response to an outbreak of Legionnaires’ disease in Edinburgh, United Kingdom, June 2012

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Cited by 22 publications

References 5 publications

Legionnaires' disease in Europe: all quiet on the eastern front?

Legionnaires' disease in Europe: all quiet on the eastern front?

Molecular diagnostics and the public health management of legionellosis

A review of back-calculation techniques and their potential to inform mitigation strategies with application to non-transmissible acute infectious diseases

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